Overview

Population Characteristics

  • This dataset include 463 confirmed cases admitted from 2018-08-05 to 2019-07-15.

  • 56% women and 2% children ≤5 years .

  • 150 confirmed deaths reported for an average CFR of 32%.

Sampling

Cases Description

Treatments and complications

These complications are inferred from laboratory results :

  • Renal impairment: Creatinine (mg/dL)≥1.1
  • Hyperkaliemia: Potassium (mmol/L)>5.5
  • Hypokaliemia: Potassium (mmol/L)<3.5
  • Rhabdomyolysis: Creatinine kinase (U/L)>1000
  • Severe hypoglycemia: Glucose (mg/dL) <60
  • Severe thrombocytopenia: Platelets (x10⁹/L) <50

Admission Delay by Outcome

Time from Onset to Admission by Outcome
Outcome N Mean (days) Median (days) IQR (days)
Deceased 147 6.1 5.0 4.5
Recovered 253 4.2 3.0 4.0

Cases and CFR

Analyses

Proposed Causal DAG of Ebola pathophysiology and outcomes

flow ImmuneMod Immune modulation DelDirect Deleterious direct effect of virus ImmuneMod->DelDirect +/- ViralLoad Viral load ViralLoad->DelDirect + OrganFail Organ failure DelDirect->OrganFail + Death Death OrganFail->Death + PreExist Pre-existing comorbidity PreExist->OrganFail + Age Age Age->PreExist +/- Sex Sex Sex->PreExist DelayedPres Delayed presentation Sex->DelayedPres Nutrition Nutrition Nutrition->PreExist + DelayedPres->ViralLoad + Vaccination Vaccination Vaccination->ViralLoad - Antiviral Antiviral therapy Antiviral->ViralLoad - Hypoperf Hypoperfusion / shock Hypoperf->OrganFail + Dehydration Dehydration Dehydration->Hypoperf + MetElect Metabolic / electrolyte derangement Dehydration->MetElect + MetElect->OrganFail + Hypoxa Hypoxaemia Hypoxa->OrganFail + Anemia Anaemia Anemia->Hypoxa + SecInf Secondary infection SecInf->OrganFail + SecInf->Hypoxa + Bleeding Bleeding Bleeding->Anemia + ORS ORS ORS->Dehydration - IVfluid IV fluid IVfluid->Dehydration - IVfluid->MetElect - Diarrhoea Diarrhoea Diarrhoea->Dehydration +

Ct threshold to predict participant outcome

  • ROC analyses were performed to determine the optimal Ct threshold to predict participant outcome.
  • With an area under the curve (AUC) of 0.85, ROC analyses evaluated the optimal Ct threshold cut-off at 23.25 for predicting patients outcome (sensitivity 79%, specificity 77%).

Logistic Regression of Factors Associated with Death and Complications

Final LASSO-selected Logistic Regression: EVD Outcome
Characteristic N n_obs Event N OR 95% CI p-value Significance1 Direction
CT at admission 354 354 134 0.69 0.63, 0.76 <0.001 *** ⬇
Delay from admission 354 354 134 1.13 1.03, 1.24 0.009 ** ⬆
    Remdesivir (GS-5734)
112
5.13 1.40, 18.7 0.013 * ⬆
    Zmapp
22
13.1 2.10, 81.8 0.006 ** ⬆
    Difficulty breathing anytime
43
5.00 1.66, 15.1 0.004 ** ⬆
    Fatigue/weakness anytime
302
3.65 1.02, 13.0 0.046 * ⬆
    Signs of dehydration anytime
40
0.29 0.09, 0.92 0.036 * ⬇
Abbreviations: CI = Confidence Interval, OR = Odds Ratio
1 Odds ratios (OR) obtained by exponentiating the logistic regression coefficients (β). OR > 1 indicates increased odds of the outcome; OR < 1 indicates decreased odds.
  • Only significant predictors are shown.
Final LASSO-selected Logistic Regression: Renal Impairment
Characteristic N n_obs Event N OR 95% CI p-value Significance1 Direction
Ebola treatment 354
40




    None
28
— —


    REGN3470-3471-3479
111
2.88 0.45, 58.7 0.35 ⬆
    Remdesivir (GS-5734)
112
1.07 0.14, 22.6 0.96 ⬆
    Zmapp
22
1.29 0.09, 35.8 0.86 ⬆
    mAb114
79
0.77 0.09, 17.2 0.83 ⬇
    REGN3470-3471-3479, Remdesivir (GS-5734)
1
0.00
>0.99 ⬇
    mAb114, Remdesivir (GS-5734)
1
0.00
>0.99 ⬇
Total NaCl administered 354 354 40 1.00 1.00, 1.00 0.067 . ⬆
Experimental treatment 354
40




    No
209
— —


    Yes
145
2.74 1.16, 6.73 0.024 * ⬆
Hyperkaliemia 354
40




    No
347
— —


    Yes
7
19.7 2.15, 219 0.009 ** ⬆
hypokaliemia 354
40




    No
344
— —


    Yes
10
12.5 2.46, 58.9 0.001 ** ⬆
rhabdomyolysis 354
40




    No
335
— —


    Yes
19
41.5 12.2, 166 <0.001 *** ⬆
Severe Hypoglycemia 354
40




    No
348
— —


    Yes
6
20.1 1.70, 239 0.015 * ⬆
Abbreviations: CI = Confidence Interval, OR = Odds Ratio
1 Odds ratios (OR) obtained by exponentiating the logistic regression coefficients (β). OR > 1 indicates increased odds of the outcome; OR < 1 indicates decreased odds.

Survival Analyses

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